Rheumatoid arthritis-like features in Hansen disease

Abstract

Rationale:Hansen disease is an infectious chronic disease with various clinical manifestations. Its joint performance may easily mimic rheumatoid arthritis.Patient concerns:We report a case of a 57-year-old woman diagnosed with Hansen disease 10 years ago, who suffered from joints swelling, pain and joints deformities of both hands for 19 years. The skin on the hands showed rashes, thickening, desquamation and chapping, with both thenar muscles atrophy. She also had severe hypoalgesia of the whole body, and morning stiffness for one hour.Diagnoses:The final diagnosis was joint damage and peripheral neuropathy due to Hansen disease.Interventions:The patient received neurotrophic treatment instead of anti-rheumatic treatment.Outcomes:At 1-year follow up, no further aggravation of joint swelling and pain was detected.Lessons:The correct diagnosis of Hansen disease involving joints depends on the combination of medical history, careful physical examination, and laboratory examination.

Leprosy-Related Chronic Arthritis with an Abundance of Mycobacterium Leprae in the Synovial Fluid: A Rare Case

“… 3 , 4 Therefore, recognition of bone and joint involvements in leprosy is important to prevent unnecessary diagnostic tests, to establish accurate diagnosis, and to give early treatment. 3 , 8 …”

“…Bone changes are one of the important prognostic factors in leprosy 7 and can be divided into three groups: specific, non-specific, and osteoporotic bone changes. 7 , 8 , 10 The frequency of bone changes has varied from 15% to 29% of leprosy cases. 7 Specific bone changes are caused by direct actions of M. leprae on bone tissues.…”

Application of bodybuilding for correction of musculoskeletal disease in Patellofemoral Pain Syndrome - A case report

“…The knee pain, especially pain related to Patellofemoral Pain Syndrome, has a high prevalence in society, affecting mainly females in the ratio of two women for one man, with an incidence of approximately 11-14% of physically inactive population, 25-40% of the people practicing physical exercises, and 36% of cyclists (Collins et al, 2018;Crossley, Stefanik, et al, 2016;Crossley, Van Middelkoop, et al, 2016;Powers, Witvrouw, Davis, & Crossley, 2017;Smith et al, 2018;Van Middelkoop, Van Linschoten, Berger, Koes, & Bierma-Zeinstra, 2008;Wood, Muller, & Peat, 2011). In the present case study, there was a failure in the initial treatment (Gao, Zhong, & Wang, 2018;Porto, 2017;Porto & Porto, 2013;Rolf, 2007), making the patient stay two years with the same problem and with the prognosis getting worse. Considering the risk of poor prognosis in the treatment, the correct diagnosis is fundamental, in this case the wrong diagnosis has not permited the correct choice of therapeutic line.…”

Clinicopathological challenge: acute blistering and dermal papules in a patient with scleroderma

“…Along with parallel clinical presentation, leprosy has been associated with autoantibody production, such as positive U1RNP, similar to profiles seen in rheumatologic disease, further complicating differential diagnosis . Leprosy can also present with purely rheumatologic symptoms, including joint damage and bone destruction, without obvious dermatologic findings . Although there is a low prevalence of leprosy in North America, rheumatologic patients with refractory symptoms despite standard therapies or changes in rash morphology, particularly in those with a history of long‐term immunosuppression or travel to disease‐endemic areas, should raise a clinical index of suspicion for an infectious etiology to ensure timely diagnosis and treatment.…”